Active NPI
Dylan Weaver
- Diagnostic Radiology Physician
- Dallas, TX
National Provider Identifier
1912601279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- V3454
- Practice address
- 3500 Gaston Ave
Dallas, TX 75246-2017 - Phone
- (214) 820-2362
- NPI assigned
- Mar 29, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Diagnostic Radiology Physician | 2085R0202X | V3454 | TX | Primary |
Addresses
Primary practice location
3500 Gaston Ave
Dallas, TX 75246-2017
Mailing address
6301 Highland Hills Dr
Austin, TX 78731-4105
Phone (512) 925-6136
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- University of Texas Medical Branch at Galveston, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
3001 E President George Bush Hwy
Suite 100
Richardson, TX 75082-3542
PO Box
Suite 911242
Dallas, TX 75391
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| V3454 | TX | MD | Diagnostic Radiology Physician |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- El Paso, TX
- NPI 1811944101
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775260800000",
"number": "1912601279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6301 HIGHLAND HILLS DR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787314105",
"telephone_number": "512-925-6136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3500 GASTON AVE",
"city": "DALLAS",
"state": "TX",
"postal_code": "752462017",
"telephone_number": "214-820-2362"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEAVER",
"first_name": "DYLAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-29",
"last_updated": "2026-04-04",
"certification_date": "2026-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "TX",
"license": "V3454",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.